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Brief Report: Use and Misuse of Thyroid Ultrasound in the Initial Workup of Patients with Suspected Thyroid Problems Referred by Primary Care Physicians to an Endocrine Clinic

Overview
Journal J Gen Intern Med
Publisher Springer
Specialty General Medicine
Date 2005 Jul 30
PMID 16050890
Citations 10
Authors
Yair Liel
Nitay Fraenkel
Affiliations
Soon will be listed here.
Abstract

Background And Objectives: Thyroid ultrasound (TUS) plays an important but limited role in the evaluation of some complaints related to the thyroid gland. This study was designed to examine how primary care physicians use TUS before referring patients to an endocrine clinic.

Design: We audited all charts of first-time referrals for appropriateness of TUS use. Recommendations in practice guidelines and current textbooks defined appropriate indications for TUS: (1) patients with a thyroid nodule and a history of head or neck irradiation; (2) follow-up of patients with nodules not surgically removed; and (3) evaluation of patients with amiodarone-induced thyrotoxicosis.

Setting: Endocrine referral clinic in a teaching hospital in Israel.

Results: Two hundred and eight unselected referrals were reviewed. Sixty-nine (33%) of the patients presented with a TUS. Documented reasons for TUS were suspected thyroid mass (n=35, 51%), thyroid dysfunction (n=21, 30%), neck pain (n=5, 7%), dyspnea (n=4, 6%), and dysphagia (n=2, 3%). Of the 69 TUS reviewed, 64 (93%) were not appropriate.

Conclusions: Primary care clinicians obtain TUS studies in patients without recommended indications prior to referral to an endocrinologist.

Citing Articles

Predictors and Consequences of Inappropriate Thyroid Ultrasound in Hypothyroidism.

Barrett K, Kennedy A, Repp A, Tompkins B, Gilbert M Cureus. 2021; 13(8):e17304.

PMID: 34567860 PMC: 8451507. DOI: 10.7759/cureus.17304.

Inappropriate use of thyroid ultrasound: a systematic review and meta-analysis.

K Edwards M, Iniguez-Ariza N, Ospina N, Lincango-Naranjo E, Maraka S, Brito J Endocrine. 2021; 74(2):263-269.

PMID: 34379311 PMC: 10292117. DOI: 10.1007/s12020-021-02820-z.

Use and overuse of diagnostic neck ultrasound in Ontario: Retrospective population-based cohort study.

Hall S, Griffiths R Can Fam Physician. 2020; 66(2):e62-e68.

PMID: 32060206 PMC: 7021338.

A pilot study examining Toronto-area family physician perspectives on thyroid neoplasm evaluation.

Kundra A, Goldstein D, Wintemute K, Ghai S, Tsang R, Gupta K J Otolaryngol Head Neck Surg. 2019; 48(1):24.

PMID: 31146769 PMC: 6543582. DOI: 10.1186/s40463-019-0349-4.

A review of the propriety of thyroid ultrasound referrals and their follow-up burden.

Davenport C, Alderson J, Yu I, Magner A, M OBrien D, Ghiollagain M Endocrine. 2019; 65(3):595-600.

PMID: 30955175 DOI: 10.1007/s12020-019-01920-1.

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